"The Senate bill is not dead," she declared. "The Senate bill will ultimately be accepted by the House and sent to he president for his signature ... because it is the only path open for health care reform."

And if House Speaker Nancy Pelosi, D-Calif., says she can't muster the votes to pass the Senate bill, Landrieu said, "she should work it harder."

And yet, the instant history of the Democrats' health-care effort may cast her as among those responsible for its demise, should it come to that.

Premature or not, post-mortems by Republican officials and conservative commentators about the sudden failure of the Democrats' health care effort consistently count the notoriety surrounding special Medicaid provisions in the bill for Louisiana and Nebraska as among the reasons the public soured on the endeavor.

Nebraska Sen. Ben Nelson, the last Democrat to back the bill, won a concession that would get his state off the hook for having to pay its share for the mandated expansion in Medicaid coverage, in perpetuity. It was dubbed, among other things, the "Cornhusker Kickback."

The Times-Picayune'I think all of those deals helped to sink it,' Sen. David Vitter said.

The FMAP refers to the percentage of a state's payments under Medicaid that are covered by the federal government. Louisiana usually gets a higher match because of how poor the state is, but because of all the recovery and rebuilding money that poured in after Hurricanes Katrina and Rita, state per capita income spiked long enough to throw the formula out of kilter and threaten to blow a hole the state budget. Landrieu's fix was, according to state officials, only the beginning of a solution for a huge Medicaid shortfall the state is facing.

"It's unfortunate people have distorted what it is, but it was widely discussed publicly, asked for by the Republican governor of Louisiana, and supported by every member of the delegation, and it was not a deciding factor in my vote," Landrieu said.

But, she conceded the Democrats' enemies made some hay out of it.

"Yes we got caught up in that," she said. But, she insisted, practically speaking, attaching the Medicaid provision to a health-care bill made sense, and there is no obvious and feasible legislative alternative.

But Sen. David Vitter, R-La., said that Landrieu's political maneuvering managed to both undermine the legislation -- for which he is glad -- and ultimately set back the effort to find an FMAP solution- which he regrets.

"I think all of those deals helped to sink it," Vitter said. "Unfortunately, in the process it completely distorted the merits of that question. I think it sets us back enormously in terms of achieving the FMAP fix. I think the merits have been completely obliterated because it's been tarred and feathered in the process of this debate."

Mario Villafuerte/The Times-Picayune archive'It's just an ugly, behind-the-scenes deal that hurts us in the long run,' Rep. John Fleming said.

Likewise, Rep. John Fleming, R-Minden, said that while the FMAP fix is legitimate and necessary, in the context of the health-care legislation, "it's just an ugly, behind-the-scenes deal that hurts us in the long run and is really only a Band-Aid for the problem."

What now, if indeed the Senate bill, contrary to Landrieu's insistence, should die.

"We are looking at all the options," said Charles Boustany, R-Lafayette. "The FMAP fix is a critical issue for the state and the delegation is united."

"Our whole delegation has been united from the beginning that we need to fix the FMAP problem, but it should be fixed on its own," Rep. Steve Scalise, R-Jefferson, said. "It's a Hurricane Katrina recovery issue, and President Obama has said multiple times that we are going to get help on the recovery."

Louisiana Secretary of Health and Hospitals Secretary Alan Levine said the state will have to prepare its budget assuming the FMAP problem will not be fixed, and then adjust the budget later if that changes.

Levine said that Rep. Anh "Joseph" Cao has a bill filed to address the issue. "I know the chances for its success are not high," Levine said, "but we need to find traction somewhere. This problem has got to get fixed."

For Rep. Charlie Melancon, D-Napoleonville, who was one of 39 Democrats to oppose his party's health care bill, and thinks it is good that they may now have to return to the drawing board, Landrieu is getting an undeservedly bum rap on the FMAP issue.

"She did what she was asked to do and then the governor didn't step up, Vitter criticized her, she was chastised by talk radio shows because she did what her governor asked her to do, it doesn't put a penny in her pocket," said Melancon. It's sole purpose, he said, is "to help the citizens of the state."

"If I were her," said Melancon, who is challenging Vitter for the Senate, "I would send a letter to the governor, 'let me know if you still want this money. ... and I want a response, because if this bill moves I want to know if you want this money and if you don't, I want to tell my leadership to take it out. Don't ask for something if you don't want it."

Former Democratic Sen. J. Bennett Johnston, now a Washington lobbyist, said Landrieu was doing what a senator is supposed to do.

"I applaud her for doing it," he said. "Look, we're a very poor state and we need all the help we can get."

But he also acknowledged that the provision was a political weight that helped drag the bill down.